IVF & THE IRAQI AMBASSADOR: Tales of Infertility

THE SET UP

Where do I start? For anyone who’s gone through it, you understand.  It’s tough. Insane. It’s a secret sisterhood.  The injections, the drugs, the blood tests, the weight gain, the crazy hormones.  We nod in a shared acknowledgment when we meet another who’s gone through the private, very painful, hell.  Some need sensitivity to cope, others find humour helps, and often we’ll seek out new alternative avenues (homeopathy, religion, acupuncture, yams) to help reduce the stress and find solace on the path to fertility.

For those lucky women who haven’t endured this unexpected twist of fate (I have friends who get pregnant when their husband just looks at them. Grrr.), it’s quite hard to explain just how mentally, physically and emotionally exhausting  IVF is for women (and by extension, their partners).  It can break you.  Or the marriage. And unfortunately, that sisterhood which bonds us ends up dividing us at the end of this challenge — those who successfully deliver a newborn baby, and those who don’t.

I got married “late” by society standards. I loved my job at ABCNews/Nightline and was in no hurry to do the marriage and family thing. I went off the pill just before we married at 36 years old. After 6 months and a doctor’s check up, I was told I had “hypothyroidism”- a condition which 30% of all women in their 30s have but most don’t know it.  It contributes to a higher rate of miscarriages, so I started on levothyroxin (synthroid in the US) and we kept going.

By 37, after both my husband and I had a comprehensive battery of tests,  it was determined that “on paper” I should be getting pregnant. Healthy, fit – perhaps somewhat stressed – but no alarm bells.  My FSH levels (follicle stimulating hormones) were good, as were my levels of oestrogen and progesterone.  We did IUI twice and nothing, so my doctor suggested we jump right to IVF as time was not on my side.

We went to a doctor said to be “the best” on the cover of Washingtonian magazine. A tall, handsome Chinese man with a calm and unpatronising demeanour, he explained to us the statistics that all IVF doctors look at. Charts and graphs showing your age going up and the viability of your eggs heading south — a huge drop off after 35 yrs old.

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I felt a bit foolish – with all the news stories I had covered – knowing so little about something so fundamental. I didn’t know that even as a healthy 20-something, you have a one in four chance of getting pregnant at each try. So by their rule of thumb, if you do 4 rounds of IVF, you should get pregnant (25% chance each time).  I started on a round of injections, drugs and doctor’s visits for blood tests.

In my head, I was “fixing” the problem. That’s the kind of person I am. A doer. Proactive. Don’t sit around and complain or worry, just get up and do something. But psychologically I had taken a blow. I could not comprehend that, from an evolutionary perspective, the one thing women are put on this earth to do, I couldn’t do. My animal instinct kicked in massively and I was devastated that I was somehow less – female – than everyone else. The insecurity planted firmly in my gut. I doubted my femininity. I wondered whether God or someone was telling me I couldn’t be a mother.  But I pushed the doubts away. I can do this! One round and we’ll be fine, I told myself.

THE FIRST TRY (or WHAT JUST HAPPENED??)

I learned how to fill needles from the vials they gave us, do that doctor thing you see in movies and tap them to get all the air holes out, and then stick the needle sub-cutaneously (under the skin) into my lower belly or the upper bottom, switching locations to avoid bruising.  The doctor told me the hormones I was injecting (to stimulate egg production) would make me bloated and perhaps irritable or weepy. I was determined not to let this affect my work or my routines so I would slip into the bathrooms at work to shoot myself up, so to speak.

At the appropriate time we went into the hospital for the operation (an anaesthetist puts you under for about 45 minutes), and later they told me I had produced 12 eggs.  Yay! They fertilised them and then watched them as they started to grow.  We went back a few days later to find 6-8 eggs looked very good but they decided to implant only the 2 best. Our hubris and optimism (stupidity?) was fatal in the end, as when they asked us if we wanted to freeze the other eggs we said no.

In the operating room for implantation, our lovely doctor had created a ‘safe space’ before there was such a word. Everyone, including my husband, was wearing surgical scrubs and masks to ensure we were in a germ-free environment. Surrounded by nurses soothingly holding my hand and stroking my forehead, we listened to lovely strains of Mozart piped in to overhead speakers.

At one end of the room the doctor opened a little sliding window and the embryologist handed off the two fertilised eggs that are attached to the end of a tiny catheter that is like a wet spaghetti noodle.  The doctor is then supposed to put this into the uterus and the eggs should attach to the uterus wall and start to grow.

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However, somewhere along the way in this process I suddenly realised the nurses had stopped cooing, they weren’t rubbing my hand nor even making eye contact. They’d moved away and were busying themselves in a nervous way.  My husband looked lost and we could feel the tension in the room.  Our doctor stood up stiffly, declaring resolutely “We’ve got a problem. I’ve dropped the eggs.”

I seriously could not comprehend what had just happened. I got up on my elbows (I was lying on my back with legs askew), looked over the edge of the operating table and said “Well, where are they? Can’t you just pick them up?” We were dumbfounded.  The embryologist had shut the window quickly — it was like they had just exposed us to a lethal disease and wanted to get as far away as possible. They quickly wheeled me out and into the ‘recovery room’ where we waited for our doctor. He came in, visibly upset, pulled up a chair, grabbed a ballpoint pen, and without anything better to write on, he started furiously stabbing at his leg, scribbling drawings and diagrams on his scrubs, explaining that as the wet-noodle catheter went up my cervix, it got caught on a ridge in my cervix and the eggs dropped off.

I still didn’t fully understand. Won’t they just swim up the rest of the way? Can’t I do a head-stand and they will drop into my uterus? Couldn’t they just hang out and grow there? He said sperm, on their own, swim. But eggs don’t. They just drop. And they won’t grow in the cervix.  He said in the thousands of times he had done this operation, and he stressed thousands, this had never, ever happened. He was horrified. He immediately said we can put in the frozen eggs to which we had to explain we told the embryologist to dispose of the extras. D’oh! He then said he’d pay for the next round. And use a hard-noodle catheter — less comfortable, but more sturdy to get over my nuisance of a cervix-ridge. As miserable as he was, I had lots of faith in him, and truth be told, when I thought about it later, he didn’t have to tell us he had ‘dropped’ the eggs. He could have “placed” them inside, and we would have been none the wiser.

But on the way home, what should have been a celebration, was a numb, silent drive where we sat there wondering what had just happened. All the build up over the weeks, the nerves, the emotions, the energy and excitement focused on this moment, sure that all would go fine, faded away and then we left with…nothing.  It was very sobering, and the beginning of a long and crazy path.

IVF & THE IRAQI AMBASSADOR

After that first disastrous IVF, the rest of them became a blur.

For context, this was 2001-2003, right after 9/11 and we were about to go to war with Iraq. We were working long, stressful days at Nightline after that fateful September morning. Our office was assigning teams to be deployed to Kuwait and the Iraqi border in anticipation of war. We had to fill out paperwork with our blood type, just in case. My doctor said “Is there any way you could take a break from work? There is so much we scientists don’t know, but we do know that stress seems to play a big factor in getting pregnant.” I told him if he wanted to keep getting paid, I needed to keep my job. At the time, IVF was about $15,000-$20,000 a pop and the health policies/laws usually allowed for only 1 or 2 to be partially covered up to a certain age (which I believe was 40 at the time).  After that, you were on your own.

On a trip up to NYC with my boss (male) on the Delta Shuttle from Washington, I remember being horrified as I realised I had my needles and vials in my backpack.  I got to the counter early and explained to the agent that we had to go up to New York to talk with the Iraqi Ambassador at the Consulate and I’m in the middle of my cycle and I have to take my medicines, but I can’t let my Executive Producer see the needles, I’m just a Producer, it’d be so embarrassing and I can’t check my backpack, that would slow us down and I’d look like an fool.  I was lucky the agent believed me. Plus this was still fairly recent post 9/11, and the strict rules were you couldn’t undo your seatbelt until 15 minutes after take off or 15 minutes before landing, and since the DC-NYC flight was half-hour, no one was moving.

Once in New York, we met with the Iraqis as they were, literally, packing up the Consulate. The US had ordered them to leave the country in a few days, ahead of the war that was imminent. I had to remember to not shake anyone’s hands during our introductions – their protocol dictates no physical contact with strange women – and I wore appropriate clothes, covering my knees, shoulders and hair, out of respect.

Amidst cardboard boxes, packing tape, and bubble wrap we sat in a beautiful room carpeted with intricate middle eastern rugs and spoke to the Ambassador about the ties we hoped to keep once war broke out.  We stated our case for keeping our lines of communication open. His press people and our sources would be in demand.  As we drank our tea out of a beautiful silver service, I interrupted: Ah, excuse me? Mr. Ambassador? Could you show me to the ladies room please?

One thing you might have guessed with IVF cycles is you are on a strict schedule and monthly calendar, and you had to inject the drugs at certain times of day in order for them to have maximum effectiveness. So there I was in the middle of the Iraqi Ambassador’s bathroom, shooting up, security cameras on me the whole time.  I left the vials and needles in the trashcan and wondered whether they thought I was a drug addict rather than someone desperately trying to get pregnant.

COPING & BECOMING UNHINGED

As a journalist, humour gets you through the darker stories you have to cover and you compartmentalise and shelve emotions so I erred towards that as a coping mechanism. But I am not one who is good with keeping things bottled up.  I needed to talk about it — with close friends and family, some co-workers. Not an emotional cry for sympathy. No, I just needed them to know what I was going through in order to give me the wide berth I required at times, or to understand why I might not be operating at 100%. I told my anchor and my executive producer in private and they were wonderful not only in respecting what I was going through, but in being genuinely curious about it. They were also shocked to find out that, in our private conversations, three other women in the office were going through it as well.

My doctor told me it’s important to take 2 months off in between IVF cycles to allow your body to recover from a month of intense hormonal injections, an operation, and post-op. Of course, I was impatient and sure I would ‘win’ on the next round. Looking back, I think successful career women in their 30s have a particularly difficult time with this because everything that has been thrown at them until now, they’ve been able to turn into gold. They are high-achieving, tenacious, ambitious, and successful perfectionists — in every aspect of their lives but one. How can this elude them?

In the blur of the next 3 rounds, here’s what I remember:

I started sticking the needles in intramuscularly (just stabbed it straight into my thigh or leg) as my belly and upper ass were getting very bruised and sore.

I remember being at a friend’s wedding and excusing myself while i pulled out my vials and needles and shot up in the Hay-Adams Hotel rooftop bathroom.

I gave away 4 tickets to a Bruce Springsteen concert because I feared standing and jumping around for 4 hours would increase the risk of the eggs falling out. (The doctors always tell you to go home and rest, put pillows under your bum, for the next several days. Didn’t that include “No Stadium Concerts”?).

I read somewhere that eating ginger makes you miscarry. I stopped eating ginger.

I read that eating yams will make you pregnant. I started eating yams and realised why I hadn’t before. I looked up recipes for yams to make them taste good and we had yams every night for a week. I think my husband was verging throwing up every time, but he didn’t say a word.

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I cried on the floor of my bedroom, completely overwhelmed with it all, bruises on my ass, needles by my side.

I went to church and prayed. Oh, Lord, did I pray. I asked for one thing, just one, and I said I would never, ever ask for anything else. Ever. I reasoned with God that when I did pray, I usually asked for help with others (the usual family and friends, pets, then I’d broaden it out to people in suffering countries, war zones, poverty, etc. Strangely, I’d always include travellers and this list would start with planes and cars and trains. But then I’d think about boats and refugees, or trains in India, or busses in South America, so my “Let all travellers get home safely today” prayer was usually very long).  But this one time, I was asking for something solely for myself. Just this once. I promised I would never do it again.

I remember with one cycle, eggs implanted and we were on the way home from the hospital, the sun was shining, my legs up on the dashboard, with the seat rolled down to almost horizontal. My husband and I are at a stop light, and he turns to me and says “Perhaps we should have a cigarette? We sorta just had sex, right?” His sense of humour kept me sane through this whole process.  There is absolutely no way I could have gotten through it without him. He was supportive, unwavering, caring, tender, and very funny. But we’ve talked since then about how medical and unromantic it was. Men tend to be fixers. This process must be extremely difficult for them too.  Anyway, he was my rock. We laughed the rest of the way home with the pillow under my bum and my feet against the windshield.

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My op and post-op demeanour was something to behold, apparently.  I’d try to talk with the doctor and nurses during the operations, pretending we had just run into each other at Starbuck’s. How are you? I would slur. Busy day? What’s your middle name? Reginald is a fabulous name!

Post-op, I was loopy but convinced I was absolutely fine. One time, I remember arguing in between giggle fits with my husband in the parking lot, convinced I was fine to drive us home (I’m fine. Of course I’m fine. FINE! I’m fine.). I sooo wasn’t fine. And he drove.

Another time, we had gotten home and I went to bed but had a call from a 4-Star General talking to me about an interview.  I had been trying to get him forever and this was a coup.  I had a long, completely coherent conversation with him, hung up, and flopped back on the bed asleep. Later, i couldn’t remember anything we discussed.

THE END GAME

At some point along the way, we had to face the reality and I needed to categorise and separate the emotions with the outcome. I had to think logically. Talking to my husband I said “What is our final goal here? At the end of this long journey, what is the brass ring?We want to be parents, right? We want to be parents of one or more children and raise them in a loving family.”  With that as our end goal, I then worked backwards as to how to get there. And looking at it that way, there were many options.

Yes, there were biological urges to be able to have a baby that genetically came from both of us, but if that avenue was exhausted there were others we could try.  There was egg donation; surrogate mothers to carry the embryos; we could pursue adoption. But initially, we absolutely wanted to try for our own child.

By the fourth attempt (5th try, after that disastrous first one which I don’t count), we’d been at it for nearly 18 months. I was reaching my breaking point.  I remember thinking, “This is it. I’m not sure I can carry on.” I felt like a bloated pin cushion and the months of trying were wearing on me. There’s only so much rejection one can take.

Whether it was the yams or the praying, or both, something worked. In the past, I’d had a few false positives only to be told the pregnancy numbers weren’t high enough and I would miscarry in the next week or so. This time my numbers were triple what they should be. I was very pregnant.

After all that effort, focus, time, energy, money, and stress, with just one short phone call from the doctor’s office, the news can be heartbreaking in sadness or heart bursting with happiness.  I will never, ever forget that day and the tears of joy that completely caught me off guard.  We went on to try another 4 times after our little girl arrived, but it wasn’t meant to be. Remember, I promised not to ask for anything else. While in South Africa, I nearly died with complications at 18 weeks pregnant.  That was long ago now, and we’ve got a typical teen – eye rolling, heavy sighs, attitude – who just this morning asked me to help quiz her on her Latin exam. She has no idea what her parents went through to bring her into the world. Kids these days, right?

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DAUGHTERS & MATHS: YOU NEED TO LISTEN TO THIS

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I can’t wait to get home tonight and listen to the Eugenia Cheng on Radio 4 this morning again, but this time with my 13-yr-old daughter.  It is so refreshing to hear someone have such a passion for what he/she does. And to explain it in a way that is ACCESSIBLE to all. 

She’s very funny when talking about the misconceptions the public has of mathematicians: “I’m not one of those people who can multiply large numbers in my head,” she laughs, “No! That’s not what we do all day!”

Replace those preconceived notions with new ones1) maths is not boring  2) you can have an interesting and well-paying job in maths 3) you can travel the globe with a maths job  4) maths is not just for boys.

It’s almost a half-hour long but flies by. Here are my key takeaways:

  • Eugenia is on a mission of ridding the world of maths phobia
  • Maths & baking have lots of similarities (as well as maths & music) — in both you are putting together a lot of ingredients and seeing whether they work or not.
  • You use lots of maths in baking. A mille feuille (delicious French pastry they often attempt on GBBO) involves rolling a pastry out and then folding it into 3, and then you roll it out again and fold into 3 again. You just need to do this 6 times and you have made more than a 1000 layers (ergo the name). Unknown-4
  • Feeling confused about math along the way? This is part of the path. Your brain will stretch.  Her childhood piano teacher would give her pieces that were way to hard for her.  She practiced and practiced and once she got to a point where she was just mastering it, her teacher would give her another, even harder piece. Maths is the same. At first it’s confusing and too hard. And then it’s not. Unknown-5
  • She goes to bars to work on her maths (love that!)
  • Good maths comes out of being lazy. It’s not about getting the right answers. She explains to her students: to be more efficient is to be lazy.  You don’t want to do the same thing over and over again so then you think, why do this over again? So let’s come up with a theory so that we don’t have to do it over and over — we’ve made it easier, quicker, simpler that way. More efficient.
  • Combine your passions for something you like to do. Recognise your strengths that are unique to you. Her mother was  “searingly” logical and her Dad was intuitive, and she feels like she got both those qualities.
  • Don’t listen to stereotypes.

On these last two takeaways, her wise words are worth delving into further.

COMBINE YOURS STRENGTHS

One of the things I’ve told my university students over the years is that I had no idea what I wanted to do after graduation. I was not one of those people who knew at the age of 16 what I wanted to do or be.

I’ve also told my students that you need to think about your strengths and use them. What makes you unique? I was smart enough but not very academic. And definitely not the smartest. I was told I was a “people person”, which I came to hate after a while. What the heck am I going to do with that? I thought.

But here’s where she crystallises what I came to realise after years of transitioning from one job to another. I was gravitating towards my strengths and applying them. On paper, yes, I have had an amazing career — surpassing any and all expectations — living and working in Argentina on my own; working in the White House; working at ABC News/Nightline, with 5 Emmys, a Peabody and a Thurgood Marshall Award for Justice to remind me of all the hard, but worthy, work; working at Foreign Policy magazine; and here in London with IES and Global Change Network. But in each of these positions, I combined strengths, priorities and environment to figure out the best path.

Eugenia makes her path sound so simple. She started GCSE’s doing maths and physics. But then she thought ‘what if I only did maths? Because that’s what I really like’. So she did just maths for her A-levels. At Cambridge, she thought ‘I really like pure maths, not applied maths’ What if I just focus on that? So she narrowed her courses. Before graduating, she thought it’d be really nice to do just algebra. Because that’s what she loves most. For her Master’s, it was category theory that captivated her. For her PhD she decided on higher dimension category theory. My high school’s motto was “Viam inveniam aut faciam” which is Latin for “I shall either find a way or make one”, something Eugenia clearly ascribed to.

After securing a Professorship at the University of Sheffield, she decided to leave. Kudos to interviewer Jim Al-Khalili for pushing her on this decision. Her response encapsulates what my subconscious told me all along (paraphrasing):

“How do I make my own way and have more effect? So I took the category theory approach to life. If you can’t be the biggest fish in the pond, what do you do? You can either grow or move to a smaller pond.  In category theory, you move to the smaller pond and look at more characteristics. I’m not the best mathematician in the world and I’m not the best public speaker in the world. But maybe I could be the best at both: a mathematician who is also a public speaker. The more things you pile on the more likely you are going to be the best of those unique combination of things.”  

She wanted to do maths and communications. She said “find all the things you are good at. Make a list. And figure out how to bring all those things together.” She said if she stopped teaching, someone would easily take her place.  But someone who can explain maths to non-mathematicians in an accessible way is unique.

Admittedly, when she mentioned she was of Chinese origin with a mathematician mother I immediately, and wrongly, thought Ah, well, that’s it. High-achieving parents, extremely disciplined, driven kids – no wonder. She did say she and her sister would fight over who got to practice on the piano (just the opposite of my sister & I  — my Mom would make us sit down to practice for an hour or no dinner).  But the overall context of her message is not who’s going to be hard-working or over-achieving or the best, it’s more about figuring out all the things you are good at and what makes you happy.

DON’T STEREOTYPE

Like Eugenia, I had parents that always instilled in me and my sister that we could be or do anything a man could. We both had no hesitation going out into the world and seeking a career, a profession, rather than a job.

From a very young age, Eugenia watched her Mom put on a suit and go to the City with briefcase in hand. Her Dad and sister would wait at the train to pick her up – a lone female amongst all the males. And it wasn’t until much later that she realised how unusual this was.

Before going to Cambridge, she was warned by her director of studies that it would be male-dominated and full of boys who will all be better than you. They will have been pushed very hard to overachieve. She thought she’d be the worst, so she was pleasantly surprised when she wasn’t the absolute worst in the class. “I had to learn to deal with their arrogance. They had been pushed hard and when they got there they breezed through. And I was surprised when later, my perseverance was helpful. As we had to work incredibly hard for our PhD’s, they had forgotten how to work hard and they fell by the wayside and I carried on.” She knocked down those stereotypes without flinching.

Kudos to Jim Al-Khalili for bringing the best out of her — he clearly loves this issue. Eugenia says “Who is combatting stereotypes of mathematicians? People assume to be a mathematician you have to be old and weird and have no friends; they must be older white guys who can’t make eye contact or are socially inept. Who will help rid the world of maths phobia with a message for the broader audience?” That is the void she hopes to fill. With this interview, she smashed it.

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Does Anyone Over a Certain Age Say This Anymore?

I was speaking to my 13-yr-old recently and coordinating weekend schedules. She wanted go to the mall with her friends to “go shopping” together. That stopped me in my tracks. I didn’t understand why at the time, but a few days later it sunk in.  What is this thing they call “going shopping together”? When would anyone find the time?

Is it just me? Am I the big loser (as The Trumpster so often says)?  I’m over 50, I work and I’m raising a child, we’ve moved continents 3 times (not country, CONTINENTS) and I’m thinking maybe all these things have contributed to my predicament. I racked my brains to think of when anyone last said those 3 little words (“Let’s go shopping!”) to me.

I do remember an Australian friend coming through London on a work trip and we had an afternoon together. We met near Regent Street and she had already stated up front in texts “We have to go shopping! I need more work clothes!”  The idea put fear in me. Perhaps it’s because I’m so bad at it? Or don’t care? I’ve never really been bothered about shopping but always loved my girlfriends who did — who would drag me out and show me what I was missing. I always needed their expertise to help me understand what looked good or what was “in” at the moment. I relied on them.  I was much more comfortable buying stuff online when that became cool — even if it didn’t fit and I was supposed to send it back for a refund (I say this because I’m too lazy and rarely did).

Anyway we went to Reiss near Piccadilly and she helped me pick out a beautiful black-and-white striped jersey Bardot top that I wear constantly. That was about 6 or 7 years ago.  She’s a self-admitted clothes horse and has a room in her house dedicated to just shoes. I think she dropped £600-£800 that weekend.  I’m not making fun at all — I’m admiring. It’s clearly a deficit of mine.  Likewise another friend in L.A. took me shopping years ago in my early 30s on Melrose Avenue and I STILL have the 3 or 4 items she hand-picked for me that I would NEVER have picked for myself. They were so cool and trendy! They don’t fit, of course, but I still have them. Thinking I can recycle them for my daughter?

Anyway, I guess I’m saying I miss it. It’s not to say I haven’t been shopping with my husband or daughter, but that’s different.  It’s less about the shopping and more about the girl talk and bonding that happens whilst shopping. Women, and men, tend to get more isolated as they get older.  Those bonding moments are fewer and far between.  So, I know my friends cannot believe I’m saying this, but sometime soon, will someone ask me to go shopping with them?

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